Left ventricular pseudoaneurysm after pericardiocentesis
Francesco Patane 1*,
Fabrizio Sansone 1,
Paolo Centofanti 1,
Mauro Rinaldi 1
1 San Giovanni Battista Hospital, Turin, Italy
* To whom correspondence should be addressed. E-mail: f_patane{at}hotmail.com.
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Abstract |
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We present the case of a patient with recurrent episodes of pericardial effusion and fever. During about one month, the patient was treated with double pericardiocentesis for cardiac tamponade and the last of them was interrupted for the suspect of left ventricular puncture due to aspiration of arterial blood from the needle used for pericardiocentesis. Considering the suspect of infective pleuro-pericarditis and patient's symptoms, a surgical drainage of the pericardial effusion was performed via right thoracotomy. The echocardiography and CT scan performed after right thoracotomy, showed only a mild pericardial effusion. Fifteen days later, the patient suffered from congestive heart failure and fever. The echocardiography and CT scanning performed urgently showed a large pseudoaneurysm (approx 26 mm x 36 mm) of the apex of the left ventricle. Ventriculography confirmed the presence of the pseudoaneurysm in connection with the left ventricular apex. Exclusion of the LV pseudoaneurysm was performed using a Prolene 0 running suture on two strips of bovine pericardium avoiding ECC use. The patient was discharged on the 7th postoperative day. Iatrogenic pseudoaneurysm caused by pericardiocentesis represents a very rare complication and it should be prevented identifying the high-risk patients. Keywords: Pericardiocentesis; Left ventricular pseudoaneurysm; Myelomonocytic leukaemia
